Interleukin-1β gene variants are associated with QTc interval prolongation following cardiac surgery: a prospective observational study.

dc.contributor.author

Kertai, Miklos D

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Ji, Yunqi

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Li, Yi-Ju

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Mathew, Joseph P

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Daubert, James P

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Podgoreanu, Mihai V

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PEGASUS Investigative Team

dc.date.accessioned

2024-01-11T15:24:54Z

dc.date.available

2024-01-11T15:24:54Z

dc.date.issued

2016-04

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Background

We characterized cardiac surgery-induced dynamic changes of the corrected QT (QTc) interval and tested the hypothesis that genetic factors are associated with perioperative QTc prolongation independent of clinical and procedural factors.

Methods

All study subjects were ascertained from a prospective study of patients who underwent elective cardiac surgery during August 1999 to April 2002. We defined a prolonged QTc interval as > 440 msec, measured from 24-hr pre- and postoperative 12-lead electrocardiograms. The association of 37 single nucleotide polymorphisms (SNPs) in 21 candidate genes -involved in modulating arrhythmia susceptibility pathways with postoperative QTc changes- was investigated in a two-stage design with a stage I cohort (n = 497) nested within a stage II cohort (n = 957). Empirical P values (Pemp) were obtained by permutation tests with 10,000 repeats.

Results

After adjusting for clinical and procedural risk factors, we selected four SNPs (P value range, 0.03-0.1) in stage I, which we then tested in the stage II cohort. Two functional SNPs in the pro-inflammatory cytokine interleukin-1β (IL1β), rs1143633 (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.53 to 0.95; Pemp = 0.02) and rs16944 (OR, 1.31; 95% CI, 1.01 to 1.70; Pemp = 0.04), remained independent predictors of postoperative QTc prolongation. The ability of a clinico-genetic model incorporating the two IL1B polymorphisms to classify patients at risk for developing prolonged postoperative QTc was superior to a clinical model alone, with a net reclassification improvement of 0.308 (P = 0.0003) and an integrated discrimination improvement of 0.02 (P = 0.000024).

Conclusion

The results suggest a contribution of IL1β in modulating susceptibility to postoperative QTc prolongation after cardiac surgery.
dc.identifier

10.1007/s12630-015-0576-8

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0832-610X

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1496-8975

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https://hdl.handle.net/10161/29746

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eng

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Springer Science and Business Media LLC

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Canadian journal of anaesthesia = Journal canadien d'anesthesie

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10.1007/s12630-015-0576-8

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

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PEGASUS Investigative Team

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Humans

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Postoperative Complications

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Electrocardiography

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Cardiac Surgical Procedures

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Risk Factors

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Prospective Studies

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Haplotypes

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Polymorphism, Single Nucleotide

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Interleukin-1beta

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Interleukin-1β gene variants are associated with QTc interval prolongation following cardiac surgery: a prospective observational study.

dc.type

Journal article

duke.contributor.orcid

Li, Yi-Ju|0000-0001-6996-4834

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Mathew, Joseph P|0000-0002-3815-4131

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Daubert, James P|0000-0002-9616-9219

pubs.begin-page

397

pubs.end-page

410

pubs.issue

4

pubs.organisational-group

Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Biostatistics & Bioinformatics

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Anesthesiology

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Anesthesiology, Cardiothoracic

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Medicine

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Medicine, Cardiology

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Institutes and Provost's Academic Units

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Duke Molecular Physiology Institute

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Initiatives

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Duke Innovation & Entrepreneurship

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Biostatistics & Bioinformatics, Division of Integrative Genomics

pubs.publication-status

Published

pubs.volume

63

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